Dataset Information

Characteristics of NPS use in patients admitted to acute psychiatric services in Southeast Scotland: a retrospective cross-sectional analysis following public health interventions.

ABSTRACT: OBJECTIVES:Assess the impact of selective prohibition and seizure of novel psychoactive substances (NPS) supply on NPS use prevalence within psychiatric admissions and evaluate demographic characteristics of current NPS users. DESIGN:A 6-month retrospective cross-sectional analysis of discharge letters between 1 October 2015 and 31 March 2016. SETTING:General psychiatry inpatients and intensive home treatment team (IHTT) community patients at a psychiatric hospital in a Scottish city. PARTICIPANTS:All participants were between the ages of 18 and 65 years. After application of exclusion criteria, 473 discharge letters of general psychiatry patients were deemed suitable for analysis and 264 IHTT patient discharge letters were analysed. INTERVENTIONS:A nationwide temporary class drug order (TCDO) was placed on 10 April 2015 reclassifying methylphenidate-related compounds as class B substances. On 15 October 2015, local forfeiture orders were granted to trading standards permitting the seizure of NPS supplies. PRIMARY AND SECONDARY OUTCOME MEASURES:The primary outcome measure was to determine the prevalence of NPS use in two cohorts. Second, demographic features of patients and details regarding their psychiatric presentation were analysed. RESULTS:The prevalence of NPS use in general psychiatry and IHTT patients was 6.6% and 3.4%, respectively. Inpatients using NPS compared with non-users were more likely to be men (OR 2.92, 95%?CI 1.28 to 6.66, P=0.009), have a forensic history (OR 5.03, CI 2.39 to 10.59, P<0.001) and be detained under an Emergency Detention Certificate (OR 3.50, CI 1.56 to 7.82, P=0.004). NPS users were also more likely to be diagnosed under International Statistical Classification of Diseases and Related Health Problems, Version 10, F10-19 (OR 9.97, CI 4.62 to 21.49, P<0.001). CONCLUSIONS:Compared with previous work, psychiatric inpatient NPS use has fallen. NPS continue to be used by a demographic previously described resulting in presentations consistent with a drug-induced psychosis and at times requiring detention under the Mental Health Act. Further research is required to evaluate the effectiveness of the recent prohibition of all NPS.

SUBMITTER: Bennett KH

PROVIDER: S-EPMC5778313 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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Characteristics of NPS use in patients admitted to acute psychiatric services in Southeast Scotland: a retrospective cross-sectional analysis following public health interventions.

Bennett Kyle H KH Hare Helen M HM Waller Robert M RM Alderson Helen L HL Lawrie Stephen S

BMJ open 20171203 12

<h4>Objectives</h4>Assess the impact of selective prohibition and seizure of novel psychoactive substances (NPS) supply on NPS use prevalence within psychiatric admissions and evaluate demographic characteristics of current NPS users.<h4>Design</h4>A 6-month retrospective cross-sectional analysis of discharge letters between 1 October 2015 and 31 March 2016.<h4>Setting</h4>General psychiatry inpatients and intensive home treatment team (IHTT) community patients at a psychiatric hospital in a Sco ...[more]

PMID: 29203502

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Project description:ObjectivesPatients admitted to psychiatric emergency services (PES) are highly heterogenous. New tools based on a transdiagnosis approach could help attending psychiatrists in their evaluation process and treatment planning. The goals of this study were to: (1) identify profiles of symptoms based on self-reported, dimensional outcomes in psychiatric patients upon their admission to PES, (2) link these profiles to developmental variables, that is, history of childhood abuse (CA) and trajectories of externalizing behaviours (EB), and (3) test whether this link between developmental variables and profiles was moderated by sex.MethodsIn total, 402 patients were randomly selected from the Signature Biobank, a database of measures collected from patients admitted to the emergency of a psychiatric hospital. A comparison group of 92 healthy participants was also recruited from the community. Symptoms of anxiety, depression, alcohol and drug abuse, impulsivity, and psychosis as well as CA and EB were assessed using self-reported questionnaires. Symptom profiles were identified using cluster analysis. Prediction of profile membership by sex, CA, and EB was tested using structural equation modelling.ResultsAmong patients, four profiles were identified: (1) low level of symptoms on all outcomes, (2) high psychotic symptoms, (3) high anxio-depressive symptoms, and (4) elevated substance abuse and high levels of symptoms on all scales. An indirect effect of CA was found through EB trajectories: patients who experienced the most severe form of CA were more likely to develop chronic EB from childhood to adulthood, which in turn predicted membership to the most severe psychopathology profile. This indirect effect was not moderated by sex.ConclusionOur results suggest that a transdiagnostic approach allows to highlight distinct clinical portraits of patients admitted to PES. Importantly, developmental factors were predictive of specific profiles. Such transdiagnostic approach is a first step towards precision medicine, which could lead to develop targeted interventions.

Project description:BackgroundA significant number of people with autism require in-patient psychiatric care. Although the requirement to adequately meet the needs of people with autism in these settings is enshrined in UK law and supported by national guidelines, little information is available on current practice.AimsTo describe characteristics of UK in-patient psychiatric settings admitting people with autism. Also to examine psychiatric units for their suitability, and the resultant impact on admission length and restrictive interventions.MethodMultiple-choice questions about in-patient settings and their ability to meet the needs of people with autism and the impact on their outcomes were developed as a cross-sectional study co-designed with a national autism charity. The survey was distributed nationally, using an exponential and non-discriminatory snowballing technique, to in-patient unit clinicians to provide a current practice snapshot.ResultsEighty responses were analysed after excluding duplications, from across the UK. Significant variation between units across all enquired parameters exist. Lack of autism-related training and skills across staff groups was identified, this becoming disproportionate when comparing intellectual disability units with general mental health units particularly regarding psychiatrists working in these units (psychiatrists: 94% specialist skills in intellectual disability units versus 6% specialist skills in general mental health units). In total, 28% of survey respondents felt people with autism are more likely to be subject to seclusion and 40% believed in-patients with autism are likely to end in segregation.ConclusionsThere is no systematic approach to supporting people with autism who are admitted to in-patient psychiatric units. Significant concerns are highlighted of lack of professional training and skill sets resulting in variable clinical practice and care delivery underpinned by policy deficiency. This could account for the reported in-patient outcomes of longer stay and segregation experienced by people with autism.

Dataset Information

Characteristics of NPS use in patients admitted to acute psychiatric services in Southeast Scotland: a retrospective cross-sectional analysis following public health interventions.

Publications

Characteristics of NPS use in patients admitted to acute psychiatric services in Southeast Scotland: a retrospective cross-sectional analysis following public health interventions.

Similar Datasets

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